Background: Severe acute maternal morbidity (SAMM) also known as maternal near miss (MNM) is defined as “Any woman who nearly died but survived as a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy”. For adequate evaluation of maternal health, all these cases should be included in analysis. Aims and objectives of this study were to analyze the cases of severe acute maternal morbidities with regards to aetiology and management. Methods: This prospective analytical study was conducted from March 2017 to August 2018. Cases of SAMM according to WHO criteria were included in the study. The data were analysed using Microsoft excel spreadsheet and SPSS software. Descriptive statistics had been used in the analysis and data had been presented as frequencies, ratios and percentages. Results: There were 14070 Obstetric admissions, 11560 live births, 248 cases of SAMM/MNM and 38 maternal deaths (MD) during the study period. MNM ratio (MNMR) was 21.45 per 1000 live births (MNMR/LB). Obstetric hemorrhage was the leading cause (37.9%) followed by hypertensive disorders of pregnancy (34.27%). Most common intervention was transfusion of blood components (63.30% cases). Majority of cases (69.35%) required 7-14 days of hospital stay. Neonatal outcome was poor-stillbirth occurred in 13.76% cases and 32.08% babies required NICU admission. Conclusion: Severe Obstetric morbidities can be prevented if they are diagnosed and managed at early stage. Review of MNM cases can greatly help to improve maternal health and to reduce maternal mortality.